Hysterotomy abortion is a

surgical procedure Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pa ...

that removes an intact

fetus A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal dev ...

from the

uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...

in a process similar to a

cesarean section Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or ...

. The procedure is generally used after another method of termination has failed, or when such a procedure would be medically inadvisable, such as in the case of

placenta accreta Placenta accreta occurs when all or part of the placenta attaches abnormally to the '' myometrium'' (the muscular layer of the uterine wall). Three grades of abnormal placental attachment are defined according to the depth of attachment and invas ...

.Roche, Natalie E. (June 16, 2006)
Surgical Management of Abortion
Retrieved July 1, 2007. In 2016, this method made up less than 0.01% of all

abortions Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of preg ...

in the United States, with the CDC reporting only 51 having occurred due to the invasive and complex nature of the procedure, and the availability of much simpler and safer methods. In 2022, scholars reported that in the aftermath of the overturning of ''

Roe v. Wade ''Roe v. Wade'', 410 U.S. 113 (1973),. was a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States conferred the right to have an abortion. The decision struck down many federal and st ...

'' and the subsequent limitations on elective induced abortion in

Texas Texas (, ; Spanish: ''Texas'', ''Tejas'') is a state in the South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2020, it is the second-largest U.S. state by ...

, providers were performing hysterotomy abortions again, under the view that it may not be technically considered an abortion under existing law.

Indications

As with other abortion procedures, the purpose of a hysterotomy abortion is to end a pregnancy by removing the fetus and placenta. This method is the most dangerous of any abortion procedure, and has the highest complication rate. The procedure is specifically indicated in the management of certain medical conditions including Cesarean Scar Pregnancy.

Procedure

Hysterotomy A hysterotomy is an incision made in the uterus. This surgical incision is used in several medical procedures, including during termination of pregnancy in the second trimester (or abortion) and delivering the fetus during caesarean section. It i ...

is major

abdominal surgery The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen ( laparotomy). Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (see stomach, kidney, liver, ...

; it is generally only performed in hospitals and other advanced practice settings. The procedure is nearly identical to a cesarean section, with two main exceptions: the administration of a feticidal injection of

digoxin Digoxin (better known as Digitalis), sold under the brand name Lanoxin among others, is a medication used to treat various heart conditions. Most frequently it is used for atrial fibrillation, atrial flutter, and heart failure. Digoxin is o ...

potassium chloride Potassium chloride (KCl, or potassium salt) is a metal halide salt composed of potassium and chlorine. It is odorless and has a white or colorless vitreous crystal appearance. The solid dissolves readily in water, and its solutions have a salt ...

before the procedure to ensure fetal demise, guaranteeing compliance with various laws on the subject, and preventing an unintended live birth; and the size of the incision, which is generally smaller than that of a cesarean section, as the fetus is generally not full term.

History

Scholarly sources place the use of this method since at least 1913. Health officials in the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...

warned practitioners against performing hysterotomy abortion in an

outpatient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care ...

setting after it led to the deaths of two women in

New York New York most commonly refers to: * New York City, the most populous city in the United States, located in the state of New York * New York (state), a state in the northeastern United States New York may also refer to: Film and television * '' ...

during 1971. The rate of mortality of abortion by hysterotomy and

hysterectomy Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries ( oophorectomy), Fallopian tubes ( salpingectomy), and other surrounding structures. Usually performed by a gynecologist, a hysterectomy may b ...

reported in the United States between 1972 and 1981 was 60 per 100,000, or 0.06%.

References

Methods of abortion Caesarean sections {{human-repro-stub